A prospective randomized trial of intraoperative bupivacaine irrigation for management of shoulder-tip pain following laparoscopy

Cunniffe, M.Geraldine; McAnena, O. J.; Dar, Manzoor Ahmad; Calleary, J.; Flynn, Noel M.

doi:10.1016/s0002-9610(98)00150-0

Cited by 125 publications

(79 citation statements)

References 13 publications

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“…21,22 Clinical studies of intraperitoneal bupivacaine had inconsistent results. Few authors have found a statistically significant difference with the useof localanesthetics 10,20,[23][24][25] others could notrepeat these results. 26,27 Furthermore in a few studies that have found a statistically significant difference with the use of bupivacaine, the difference between the average pain scores was lessthan 1 in a scale of 10.…”

Section: Discussion:-mentioning

confidence: 99%

Intraperitoneal Bupivacaine for Postoperative Pain Relief After Laparoscopic Cholecystectomy.

Ijar¹,

Singh²,

Parvez³

et al. 2017

IJAR

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Section: Discussion:-mentioning

confidence: 99%

Intraperitoneal Bupivacaine for Postoperative Pain Relief After Laparoscopic Cholecystectomy.

Ijar¹,

Singh²,

Parvez³

et al. 2017

IJAR

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“…Again, a few studies have shown that the incidence of shoulder tip pain is more after Nissen's fundoplication and other crural surgeries than after laparoscopic cholecystectomy [1]. Injury to the crura and bleeding during the procedure lead to a higher risk of shoulder pain [5].…”

Section: Discussionmentioning

confidence: 99%

“…Although laparoscopic cholecystectomy has emerged as the gold standard in gallbladder surgery with its advantages, including less postoperative pain and earlier ambulation with return of normal activities, it is not without its undesirable side effects, of which shoulder tip pain is a troublesome symptom [1,2]. Reasons proposed as causes of shoulder pain is stimulation of the sympathetic nervous system by hypercarbia [3], the residual pneumoperitoneum after the surgery, and rapid distention of the abdomen by carbon dioxide [2].…”

Section: Introductionmentioning

confidence: 99%

Shoulder Tip Pain Following Laparoscopic Cholecystectomy—a Randomized Control Study to Determine the Cause

Dey

Malik

2013

Indian J Surg

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The aim of this study was to determine the effect of low-pressure pneumoperitoneum and duration of surgery in laparoscopic cholecystectomy on postoperative shoulder tip pain. A total of 100 patients were assigned into two groups depending on the intraperitoneal pressure during laparoscopic cholecystectomy. Group A included patients in whom the intraperitoneal pressure was 13-15 mm of Hg and group B included patients who underwent surgery at 10-12 mmHg. Each group was then subdivided into two subgroups depending on the duration of surgery. In the first subgroup, the duration of surgery was less than 1 h and the next subgroup included patients who took more than 1 h. Presence or absence of shoulder tip pain was recorded within 4 h, at 24 h, and at 48 h. Total number of patients having shoulder tip pain in the lower pneumoperitoneal group was more than the higher pneumoperitoneal group in both subgroups, P values >0.05. More patients in the <1 h subgroup had shoulder tip pain as compared to the >1 h group at both pneumoperitoneal groups, P values >0.05. Shoulder tip pain was most at 24 h and gradually decreased thereafter. In our study, intra-abdominal pressures and shorter duration of surgery were factors unrelated to incidence of shoulder tip pain after laparoscopic cholecystectomy.

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“…2,3 The duration of convalescence after uncomplicated laparoscopic cholecystectomy depend on several factors of which shoulder tip pain is more important. 4 Other are nausea, vomiting, ileus, postoperative fatigue, postoperative hospital stays, recovery time. Shoulder tip pain frequently occurs after laparoscopic cholecystectomy making postoperative recovery less comfortable.…”

Section: Introductionmentioning

confidence: 99%

Outcome analysis of low pressure versus high pressure pneumoperitoneum laparoscopic cholecystectomy: a randomized clinical study

et al. 2017

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Background: Laparoscopic cholecystectomy is established as gold standard for management of cholelithiasis. Intraoperative pneumoperitoneum affects the postoperative outcomes. The current stress is on increasing patient safety. Hence, this prospective study was undertaken to compare the effect of low pressure pneumoperitoneum (LPP <10 mm Hg) versus high pressure pneumoperitoneum (HPP > 14 mm Hg) on postoperative pain and ileus.Methods: 120 patients undergoing laparoscopic cholecystectomy were randomized into the LPP (<10mm Hg) group (n=60) and the HPP (>14 mm Hg) group (n=60). Total duration of surgery, intra-operative gas consumption, occurrence of bile spillage during operation, shoulder pain and abdominal pain in postoperative period, additional requirement of analgesia in postoperative period and postoperative ileus were assessed.Results: There was no significant difference in terms of operative duration, consumption of CO2 gas, intraoperative bile spillage, total hospital stay and tolerance to early feeding. The incidence of shoulder pain was higher in patients who underwent HPP laparoscopic cholecystectomy (p<0.05). There was early recovery and early return of bowel activity in LPP which was statistically significant.Conclusions: Low-pressure pneumoperitoneum is feasible and safe and results in reduced postoperative shoulder tip pain and near-equal operative time with early return of bowel activity compared with high-pressure pneumoperitoneum.

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A prospective randomized trial of intraoperative bupivacaine irrigation for management of shoulder-tip pain following laparoscopy

Cited by 125 publications

References 13 publications

Intraperitoneal Bupivacaine for Postoperative Pain Relief After Laparoscopic Cholecystectomy.

Intraperitoneal Bupivacaine for Postoperative Pain Relief After Laparoscopic Cholecystectomy.

Shoulder Tip Pain Following Laparoscopic Cholecystectomy—a Randomized Control Study to Determine the Cause

Outcome analysis of low pressure versus high pressure pneumoperitoneum laparoscopic cholecystectomy: a randomized clinical study

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